| NPI | 1699897074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: HI 3393) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA 119347) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: HI 1115-02) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2024-05-28 |